Vulvodynia's $18,000 a Year Cost + a Mini Interview With Origin CEO Carine Carmy

What does it actually cost to get diagnosed with vulvodynia in America, and what happens in the absense of adequate care? In this episode, I sit down with Carmen Rising, a writer based in Brooklyn who covers vulvovaginal pain and systemic problems in healthcare, with bylines in The New York Times, The Guardian, Los Angeles Times, and Teen Vogue. She holds an M.A. in Cultural Reporting and Criticism from New York University, and came to this reporting as a patient herself - it took her nearly a decade to get a proper diagnosis, and that lived experience runs through everything she writes. — This episode is kindly sponsored by Pelva. Use code TWTC10 at checkout to receive 10% off your first order. (I earn a commission if you purchase through my link.) I am so proud to announce my partnership with Origin. Use promo code TWTC to get your first month of Origin's On-Track membership free.  — We start with her Guardian piece and the number that opens it: women in the US with vulvodynia incur costs averaging around $18,000 a year, part of a broader $31 to $72 billion annual economic burden. We get into exactly where that money goes - the average of eight providers before a diagnosis, the specialists who operate entirely outside insurance, and a system Dr. Rachel Rubin describes as "a dumpster fire of brokenness." Carmen explains why there often isn't even a billing code for these conditions, and what grassroots efforts like the Aziza Project and Tightlipped are up against when they try to close that gap one patient at a time. We also talk about the risk, raised by Elizabeth Hinz, that this becomes framed as a wealthy white woman's problem. From there we move to Carmen's New York Times piece on the vaginal wellness boom - the wave of direct-to-consumer products making vague, unregulated diagnostic claims, and the murky world of at-home vaginal microbiome testing kits that promise more certainty than the science can actually back up. I also introduce our new podcast partner, Origin, and sit down with co-founder and CEO Carine Carmy for a short conversation about her own decade-long journey with pelvic pain and why she built a company to make pelvic floor physical therapy accessible. **Links to the articles we discuss:**  - The New York Times: "The Vaginal Wellness Boom Is Here" - The Guardian “‘They’ll pay anything to feel better’: the expensive problem of pelvic pain” **Connect with Mathilde:** - IG: @theworldstightestcommunity - Website: theworldstightestcommunity.com - Sign up to the newsletter • Support the podcast